Dr. Elizabeth Bradley's long-term career goal is to study Graves' opthalmopathy as an independent clinical investigator. This application proposes a two-phased career development program that will provide her with many of the tools necessary for future success. In the first two years of the award period, Dr. Bradley will complete course work through the Johns Hopkins School of Public Health's Graduate Train Program in Clinical Investigation. Johns Hopkins ophthalmic epidemiologic Dr. Sheila West will serve as primary mentor throughout the award period. Dr. Bradley will spend the final three years of the award at the Mayo Clinic, completing a study on the impact on Graves' opthalmopathy on health-related quality of life under the guidance of Mayo-based co-mentor Dr. Rebecca Bahn. Johns Hopkins offers Dr. Bradley a mentor with expertise in ophthalmic clinical investigation and the many resources of both its School of Public Health and the School of Medicine's Wilmer Eye Institute. The Mayo Clinic offers a mentor actively engaged in clinical investigation in Graves' opthalmopathy practice, and the resources of an established, NIH-funded quality of life research program. Graves'' opthalmopathy is an infiltrative orbital disease associated with autoimmune thyroid disease. Although medical and surgical interventions have been reported to improve some of the manifestations of the disease, the associated side effects of current treatments for Graves' opthalmopathy often temper their benefits. Additionally, objective indices by which to measure many of the disease manifestations are lacking. These objective measures that do exist fail to provide a comprehensive assessment of the impact of the disease and its treatment on patient health-related quality of life. Dr. Bradley plans to develop a valid, reliable Graves' opthalmopathy-specific HRQL instrument and to obtain baseline epidemiologic data on the performance of the instrument in a population of Graves' opthalmopathy patients. These efforts will serve as important preparatory steps toward Dr. Bradley's long-term goal of studying treatments of Graves' opthalmopathy through medical and surgical clinical trials.